Letter to the Editor

Published: September 22, 2017

Dear Mr. Spencer,

In the July edition of the Birmingham Medical News, an article titled RNs Seek Independence, Expanded Responsibility through Advanced Training, implied that nurse anesthetists working unsupervised provide care equivalent to, or even better than, the care they provide under the supervision of a physician. We disagree. There are no valid studies to support this. On the contrary, studies show there are significantly better patient outcomes, reduced mortality and cost savings when a physician anesthesiologist leads the care of surgical patients as compared to a nurse anesthetist working alone.

We work closely with nurse anesthetists, supervising them as physician anesthesiologists as we care for our patients in the operating room. Under the supervision of a physician, they are a valuable part of the anesthesia care team. However, their education, training and experience is as a nurse and, therefore, completely different from that of a physician. We have all known and worked with physician anesthesiologists who were nurse anesthetists before deciding to go to medical school. Each and every one of them states that the depth and breadth of education they received in medical school and residency was far greater and very different from what they had received in nursing school and nurse anesthetist training.

The requirements to become a nurse anesthetist are a bachelor's degree in nursing followed by one year of experience working as a nurse in an acute care setting which is then followed by a master's training program that involves 1,600 to 1,700 hours of clinical training. All said and done, that is seven years of education after high school.

To become a physician anesthesiologist, one must complete a bachelor's degree followed by four years of medical school and four years of residency. This takes 12 years and over 12,000 hours of clinical training after high school. It is clear that becoming a physician anesthesiologist requires five more years and over 10,000 more hours of clinical training. On top of this, as mentioned above, the focus of the education and training is different for a physician than it is for a nurse.

There is no doubt that nurses play a very important role in caring for patients; one that is completely different, however, from that of a physician. Patients deserve to have a physician involved in all aspects of their health care and particularly in the operating room where critical decisions and timely interventions are being made when seconds count.